DeSantis health plan calls for more patient choices

Less than two weeks before Election Day, Republican gubernatorial nominee Ron DeSantis has released a plan that he promises would help transform Florida’s health-care system.

After weeks of criticism over his lack of a health-care plan, DeSantis posted the proposal online Wednesday shortly before his final debate with Democratic candidate Andrew Gillum. The plan calls for people to have the right to buy the health care they want; use price-transparency tools to shop for care; and get rebates from insurers when patient choices save money.

The plan said DeSantis would maintain quality care by “resisting any effort to ration health care” in Tallahassee.

“Floridians have more choices in picking out their cell phone plans than their health insurance plans. Every day in the grocery store, we make decisions about what we want to buy, weighing price, necessity, and quality, and deciding what’s right for us,” the proposal said. “But, when it comes to something as important as health care, we have fewer choices and less information.”

DeSantis and Gillum have tangled in two debates this week about health care.

Gillum strongly supports expanding Medicaid eligibility as allowed under the federal Affordable Care Act. Gillum has also expressed support for “Medicare for all,” a single-payer system championed by Vermont Sen. Bernie Sanders that would require federal approval.

DeSantis, who resigned his Northeast Florida congressional seat last month to focus on the gubernatorial race, opposes Medicaid expansion and has lambasted Gillum over supporting “Medicare for all.”

While in Congress, DeSantis was a member of the House Freedom Caucus a group of conservatives who did not support President Donald Trump’s efforts to repeal and replace the Affordable Care Act, better known as Obamacare. DeSantis and others in the group maintained at the time that the efforts didn’t go far enough.

Some of the ideas cited in DeSantis’ new plan have already been percolating in the GOP-controlled Florida Legislature, including a House proposal that would have mandated insurers and health-maintenance organizations share savings with consumers who shopped for care. The 2017 legislation, which ultimately did not pass, would have opened up insurers for penalties or lawsuits if they failed to comply.

The DeSantis plans also calls for expanding what is known as direct primary care, a concept that the Legislature approved this year. Direct primary care involves contractual arrangements between doctors and patients for treatment, at least partially cutting out the role of insurers. It’s not clear how DeSantis would want the plans expanded.

Democrats, who have attacked DeSantis for his opposition to the Affordable Care Act, immediately blasted his new proposal. In part, they said it would allow the sale of what they consider “junk” health-care plans, or those that don’t meet minimum benefit requirements of the Affordable Care Act.

Moreover, Democrats argued the DeSantis proposal would not help people with pre-existing medical conditions. A popular feature of the Affordable Care Act provides protections in purchasing insurance for people with prior health conditions.

According to the DeSantis proposal, the Republican gubernatorial candidate would “work to ensure hard-to-insure Floridians with significant health needs have access to coverage” through market reforms that will encourage people to buy policies “before they get sick.”

Johanna Cervone, a Gillum spokeswoman, criticized the plan.

“After 268 days without a health-care plan, Ron DeSantis finally released a sham of a proposal that puts special interests over the health of Floridians and denies coverage to people with pre-existing conditions,” Cervone said in a statement.

Florida Republican Attorney General Pam Bondi has joined 19 other GOP attorneys general in a federal lawsuit that, if successful, would overturn the pre-existing protections contained in federal law.

According to the Kaiser Family Foundation, Florida has 3.1 million non-elderly people with pre-existing conditions.

Central to the DeSantis health-care proposal is the idea that costs must be contained to expand access.

To that end, DeSantis said he would “aggressively” implement an all-payer claims database designed to provide more information about prices. Gov. Rick Scott pushed for passage of the database in 2016, a year after a bruising legislative battle over expanding Medicaid access for uninsured, childless adults. In lieu of expanding Medicaid, Scott said he would help uninsured Floridians by working to lower the cost of care and touted increased transparency as a key way to do that.

But some of the largest insurance carriers aren’t reporting the information, after the state awarded a database contract to the Health Care Cost Institute, which was founded in 2011 by four insurance companies, including three that do business in Florida: Aetna, Humana and UnitedHealthcare.

Another health-care move championed by Scott and supported by DeSantis is the state’s Medicaid managed-care program. Lawmakers and Scott in 2011 approved the program, which requires most Medicaid beneficiaries to enroll in HMOs or other types of managed-care plans.

DeSantis’ proposal said that as governor he would continue to “support Florida’s groundbreaking Medicaid managed-care model.”.

DeSantis in his proposal also said he would “finish implementing Florida’s medical marijuana constitutional amendment.” Voters in 2016 approved a constitutional amendment that broadly legalized medical marijuana, but the state has faced lawsuits and criticism about the way it has carried out the amendment.